Exc feenl mal+mrg 0.6-1 11641 at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
not published by hospital
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
not published by hospital
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$97.65 with United Healthcare Community Plan for Families vs $1,861.98 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| United Healthcare Community Plan for Families | Unison MedPLUS | $97.65 | — |
| UPMC Health Plan | Managed Medicaid | $102.30 | — |
| United Healthcare Community Plan for Families | Unison Kids | $106.95 | — |
| Aetna | Medicaid | $116.25 | — |
| Geisinger | Medicaid/CHIP | $129.26 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $137.92 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $140.24 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $145.18 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $158.49 | — |
| Aetna of PA | Medicare | $242.02 | — |
| UPMC Work Partners | Workers Comp | $421.58 | — |
| UPMC Health Plan | Managed Medicare | $578.49 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $670.79 | — |
| Aetna | Medicare | $690.91 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $692.39 | — |
| United Healthcare | Medicare | $717.75 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $724.39 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $724.45 | — |
| AmeriHealth Caritas | Medicare | $724.45 | — |
| Cigna | Medicare | $724.45 | — |
| UPMC Health Plan | Commercial | $954.96 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,511.46 | — |
| UPMC Health Plan | CHIP | $1,731.41 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,861.98 | — |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc feenl mal+mrg 0.6-1 11641 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,371.60 | $39.09 – $2,094.25 |
| UPMC Kane | Kane | $662.40 | $102.30 – $991.77 |
| UPMC Magee | Pittsburgh | $2,579.40 | $102.30 – $724.45 |
| UPMC Passavant-McCandless | Pittsburgh | $2,579.40 | $102.30 – $737.87 |
| UPMC Presbyterian | Pittsburgh | $3,123.60 | $102.30 – $931.20 |
| UPMC St. Margaret | Pittsburgh | $2,574.60 | $102.30 – $550.23 |
| UPMC Wellsboro | Wellsboro | $1,534.40 | $102.30 – $993.28 |
| UPMC Williamsport | Williamsport | $490.80 | $102.30 – $993.28 |